VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 1009907
Sex: F
Age: 42
State: TX

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None reported

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient received vaccine in left deltoid at 3:40PM. During observation she became dizzy and fainted in seated position at 3:50PM. She came to immediately with the pharmacist talking to her and grasping her shoulders. Her BP at 3:51PM was 120/83 with HR of 60. Patient admitted to fasting for two days prior. She was administered Glutose gel sublingually at 3:54PM and BP was 107/81 with HR 69. She began to feel less faint with color returning within 2 minutes of administration of the glucose. She was observed until 4:10PM without any further incident. She was released with pharmacist's recommendation to go to the ER if any other symptoms are experienced.

Other Meds: None--Patient had been fasting

Current Illness: None reported

ID: 1009908
Sex: F
Age: 58
State: NJ

Vax Date: 01/21/2021
Onset Date: 02/07/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Yellow Rice

Symptom List: Anxiety, Dyspnoea

Symptoms: Moderna COVID-19 Vaccine EUA Red rash developed 11 days after vaccination. Sore arm with itch.

Other Meds: Lexapro 5 mg Aspirin 51 mg Vitamin D 1000u Naproxen Sodium 220 mg OD Nasacort (1 spray in each nostril daily) Multi Vitamin

Current Illness: None

ID: 1009909
Sex: F
Age: 43
State: IN

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: Fever, chills, aches and headache

Other Meds: N/A

Current Illness: N/A

ID: 1009910
Sex: F
Age: 65
State: CA

Vax Date: 01/27/2021
Onset Date: 02/04/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: On day 8 itchy arm, swelling, redness, arm hot to touch , by day 12, half of upper arm swollen, red, hot, occasionally itchy. Condition has worsened day 8-12

Other Meds: Levothyroxine Metformin Atorvastatin

Current Illness:

ID: 1009911
Sex: F
Age: 27
State: IL

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Received the Maderna Covid Vaccine. I experienced flu-like body aches including headache the next day. The following day I developed itchiness and swelling at injection site, but my other symptoms improved greatly.

Other Meds:

Current Illness:

ID: 1009912
Sex: F
Age: 23
State:

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none known

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: 100.4 degree fever at 4am after dose accompanied by chills, sweats, and headache nausea at 2pm on 2/6

Other Meds: tri-lo-sprintane vitamin d elderberry supplement biotin supplement

Current Illness: none

ID: 1009913
Sex: F
Age: 14
State: PA

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient became light headed, her vision went and she was staring off, became pale. Lasted for a brief period. No syncope. Resolved with laying down and drinking some juice. Completely resolved within 15 minute

Other Meds: zoloft

Current Illness: none

ID: 1009914
Sex: M
Age: 57
State: IN

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No

Symptom List: Pharyngeal swelling

Symptoms: Pain at shot location, fever, body aches

Other Meds: Tylenol, ibuprofen

Current Illness: No

ID: 1009915
Sex: F
Age: 39
State: IL

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Chills and aches lasting 24 hours. L arm continues to experience numbness and tingling like my arm was asleep

Other Meds: Procardia Spirolactolone

Current Illness:

ID: 1009916
Sex: F
Age: 33
State: MD

Vax Date: 01/05/2021
Onset Date: 01/11/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Allergy to beets

Symptom List: Diarrhoea, Nasal congestion

Symptoms: One week after receiving the first dose the injection site became red, itchy, swollen, and very warm. Within 12 hours of the start of the reaction the redness and swelling spread throughout my entire upper arm. The swelling and redness lasted about 4 days.

Other Meds: Post natal vitamin

Current Illness: None

ID: 1009917
Sex: F
Age: 65
State: CA

Vax Date: 01/01/2021
Onset Date: 02/06/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Linisiprol

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: 10 days after shot I have a 4 inch round redness that is hot around injection site

Other Meds: Losartin, Symbacort

Current Illness:

ID: 1009918
Sex: F
Age: 55
State: SC

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Patient received vaccine on 2/5/21- wasn't feeling well ( day after headache, on and off fever, sore throat) We discussed that symptoms could correlate to other possible illnesses and discussed being seen , possibly getting COVID testing as well.

Other Meds:

Current Illness:

ID: 1009919
Sex: M
Age: 74
State: CA

Vax Date: 02/07/2021
Onset Date: 02/07/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Patient felt lightheaded but resolved after resting

Other Meds: Amlodipine, Oxybutynin, Zoloft, Simvastatin, Oxcarbazapine

Current Illness: None

ID: 1009920
Sex: F
Age: 42
State: NY

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None known

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: Headache, Chills, Nausea, Fatigue, Muscle Aches. I slept for approximately 18 hours with really bad chills.

Other Meds: Venlafaxine, vitamin B

Current Illness: Had Covid and isolation ended January 30th. I checked with health care provider and dept. of health and they both said it was okay to get vaccination.

ID: 1009921
Sex: F
Age: 47
State: PA

Vax Date: 02/03/2021
Onset Date: 02/05/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Dilantin, oranges

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: By 2nd night my hands and feet were freezing.. I felt extremely cold but had no fever and didn't feel sick.. By third night my lower back down thru my hamstrings and half muscles were weak and extremely sore. It felt like I overworked my muscles but I didn't workout or strain myself during this vaccination and thereafter. Hopeful few days soreness will be gone. Just wanted to report what I'm experiencing so far. Used heating pad and advil.

Other Meds: Vit d 2000iu daily 6am, iron supplement 6am Donezpezil 6am. Metoprolol 25mg at 6am.

Current Illness: None

ID: 1009922
Sex: F
Age: 46
State: MO

Vax Date: 01/30/2021
Onset Date: 02/06/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: 'Covid-arm' developed overnight on the 7th day. Swelling, itching, redness, warm to touch, tenderness

Other Meds: Yasmin, effexor, synthroid

Current Illness:

ID: 1009923
Sex: F
Age: 50
State: NM

Vax Date: 02/02/2021
Onset Date: 02/04/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: No

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: Immediately after 2nd injection, sensitivity to light & color. Hot and sweaty for 24 hours, then cold & clammy, jumbled though and speech. Soreness at injection site. Extreme tiredness. 2-days after injection, swelling of piriformis muscle in hip, extreme pain, bedridden, unable to walk, fever, for going on 36 hours. Taking 800 mg ibuprofen to sleep. Muscle cream, Epson salt baths to reduce pain.

Other Meds: Triphala, magnesium, aloe vera

Current Illness: None

ID: 1009924
Sex: M
Age: 50
State: ME

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: CONTRAST DYE, PCN, TREE NUTS

Symptom List: Ear pain, Hypoaesthesia

Symptoms: chills, sob, wheezing cough congestionb

Other Meds:

Current Illness:

ID: 1009925
Sex: F
Age: 43
State: AL

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: At injection site: soreness, redness, hot to the touch, swollen/knot about the size of a lemon, itching. These symptoms were present the morning after the injection.

Other Meds: Zyrtec Metoprolol Succinate ER 100 Women?s Multivitamin

Current Illness: None

ID: 1009926
Sex: M
Age: 26
State: TN

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies: Shellfish (nausea/vomiting)

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: numbness/tingling in face for 5 - 10 minutes

Other Meds: Atorvastatin 20 mg Zyrtec Xyzal

Current Illness:

ID: 1009927
Sex: M
Age: 50
State: MS

Vax Date: 01/27/2021
Onset Date: 02/02/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None that I'm aware of

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: On day 5 armpits felt tender & sensitive, day 6 itching at injection site, day 7 rash at injection site and other parts of the body mainly upper torso area. Rash to the left and right of navel, armpit area, left & right side of chest were little more prevalent but some small red bumps on arms, should & back area as well

Other Meds: - Zyrtec daily in the morning - Probiotic daily in the morning - Supplements: Elderberry, Vitamin D3, Zinc, Turmeric, Milk Thistle, Fish Oil, Vitamin C, Lion Mane Smart Shrooms & one Nootropic at times (approx. every other day). - Healthy

Current Illness: None

ID: 1009928
Sex: F
Age: 50
State: WA

Vax Date: 02/04/2021
Onset Date: 02/06/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: Mild hives on neck and chest were noted before going to bed on 2/6. An antihistamine was taken (Aller-tec). On morning of 2/7 hives were significantly worse and had spread to torso. An Allegra pill was taken around 1 pm.. There have been no changes in hives.

Other Meds: Dextroamphetamine sulfate; progest?rone micronized; Vitamin C; Vitamin D; align probiotic; tizanidine.

Current Illness: Potential side-effects from 1st dose on 1/7: headache, fatigue, diarrhea

ID: 1009929
Sex: F
Age: 40
State: GA

Vax Date: 01/29/2021
Onset Date: 02/06/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Mangoes

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: ?COVID-19 arm? approximately 2? swelling, redness, itching, and tenderness at injection site

Other Meds: Birth control (Katlib FE)

Current Illness: None

ID: 1009930
Sex: M
Age: 78
State: FL

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site pain, Pain

Symptoms: Fever of 103.1 degrees

Other Meds: amlodipine besylate 10mg dextroamphetamine 10mg omeprazole 20mg

Current Illness: n/a

ID: 1009931
Sex: M
Age: 32
State: IL

Vax Date: 01/30/2021
Onset Date: 02/06/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: One week after my first Moderna dose, I noticed an enflamed reaction at the injection site. There is mild itching and a red area about 2.5 inches in diameter. I did not notice this reaction in the days immediately following the shot. I did, as expected, experience moderate soreness in my left arm for 2-3 days. Is it recommended to receive the second dose in the opposite arm?

Other Meds: 1 a day men's multivitamin

Current Illness: None

ID: 1009932
Sex: F
Age: 74
State: MT

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Benzoin Ibuprofen Penicillins Aspirin (tinnitus)

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: I was very concerned that the vaccine injection was not done correctly, and not done in the right place. Instead of doing an IM in the deltoid, the shot was a subq just above the elbow. At first, a large red welt (10 x 8 cm.) appeared soon after. Four days later, when I went to the clinic, it was improved. Photos were taken.

Other Meds: Potassium Chloride Er 10 ME 2 tabs/day Multi Vit 1 tab/day Triamterene-HCTZ 37.5-25 mg 1 tab/day Tamoxifen 20 mg 1 tab/day Methocarbamol 500 mg 1 tab prn Betamethasone Valerate Lotion USP, 0.1% prn Citracal Maximum Plus 4 tabs/day Tylenol

Current Illness:

ID: 1009933
Sex: F
Age: 67
State: FL

Vax Date: 01/05/2021
Onset Date: 01/08/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Unknown

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Posterior vitreous detachment. After each vaccine left eye first then right. 3 days after vaccine.

Other Meds: VitaminD

Current Illness: Eye stye

ID: 1009934
Sex: F
Age: 56
State: IN

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NKA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Approx 1 1/2" Localized red, raised, firm, warm area @ injection site-morning after injection and still present @ report time.

Other Meds: Synthroid 75 mcg Lipitor 20mg

Current Illness: None

ID: 1009935
Sex: F
Age: 22
State: CO

Vax Date: 01/27/2021
Onset Date: 02/07/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Penicillan

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Red rash on left arm near injection site. Warm to the touch.

Other Meds: Effexor Kylena Marijuana

Current Illness:

ID: 1009936
Sex: M
Age: 35
State: WA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NKDA

Symptom List: Nausea

Symptoms: Low-grade fever, injection site pain and swelling, axillary pain and swelling, mild fatigue, mild aches and chills. Treated with 400 mg IBU PRN.

Other Meds: None

Current Illness: None

ID: 1009937
Sex: F
Age: 63
State: AZ

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Cipro Bactrim Brethine Levaquin Erythromycin Augmentin

Symptom List: Injection site pain

Symptoms: Thick Tongue, itching face, head, arms legs, increased temperature, headache, muscle pain

Other Meds: Breo Spiriva Spirnalactone Singular synthroid Aspirin Protonix Diclofenac Simvistatin Multivitamin Fish Oil Vitamin C Biotin

Current Illness:

ID: 1009938
Sex: F
Age: 38
State: GA

Vax Date: 12/30/2020
Onset Date: 01/05/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: redness and swelling around the injection site. Redness was the size of a gold ball. Swelling - moderate. Some itching as well - mild Noticed above around 5-6 days after the vaccination. Went away about 24-36hrs after i first noticed it

Other Meds: multivitamin saw palmetto vit d3 b12

Current Illness: none

ID: 1009939
Sex: F
Age: 36
State: TX

Vax Date: 01/28/2021
Onset Date: 02/05/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: N/a

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: Approx 8 days after vaccine itchy red spot appeared around injection site. 2 in round shape, swollen and firm. Contacted PCP, no immediate concern. Benadryl for itching if needed and cool compress. Day 9 red spot increased in size move down the arm towards elbow. Original 2in spot redness is less. Day 10, same as day 9. Red swollen itchy spot increased but the original spot is not as red and swelling is going down. Date of sumission is day 10 and reaction is still occurring. No worsening of itching, swelling. Only increase in size every day moving down the arm towards elbow. On day 10 size of total area is approx 6 in long and 3 in wide.

Other Meds: Diamox, Nutrafol Hair Growth Vitamins, women?s one a day multi vitamin, vitamin b super complex

Current Illness: None

ID: 1009940
Sex: F
Age: 71
State: KY

Vax Date: 02/07/2021
Onset Date: 02/07/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: The patient had pressure pain above elbow then moved to forearm (pain scale 3-4). Then patient moved to a dull ache, pinpoint above wrist with patient scale of 1.

Other Meds:

Current Illness:

ID: 1009941
Sex: F
Age: 65
State: TX

Vax Date: 02/05/2021
Onset Date: 02/07/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Biaxin, keflex

Symptom List: Erythema, Pruritus

Symptoms: Red, Very swollen injection site, including axillary area, fluid filled. Injection site very close to shoulder joint.

Other Meds: HCTZ, Protonx, Amilodpine, melatonin, synovix, famitidine,

Current Illness: Upper respiratory infection 1/7/21

ID: 1009942
Sex: F
Age: 52
State: IN

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies: NKA

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: Chills, fever, body aches, headache

Other Meds: Metformin Lipitor

Current Illness: None

ID: 1009943
Sex: F
Age: 40
State: GA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Skin rash with tingling sensation and warm to touch at injection site , about 6 inches down from deltoid to bicep on left arm. Symptoms appeared about 12 hours after injection and duration has been approximately 48 hours but has not resolved yet.

Other Meds: None

Current Illness: None

ID: 1009944
Sex: F
Age: 66
State: FL

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Mold

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Mild fatigue, muscle soreness, body aches, occasional chills (no fever). All symptoms were minor and did not require treatment. Most lasted 24 hours, mild fatigue lasted 36 hours. This was my second vaccination. Only slight muscle soreness with the first vaccine.

Other Meds: Glucosamine, B complex, E, D3, Magnesium, Claritin 24 hour

Current Illness: none

ID: 1009945
Sex: F
Age: 44
State: WA

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: No

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Headache, chills, hot flashes, severe injection are pain, swelling at injection site that spread to lymph nodes near site, nausea. Unable to work. Stayed home, iced arm, and took Ibuprofen for pain. Symptoms gone within 24 hrs. Arm still sore but better.

Other Meds: Multivitamin, vitamin D3, allegra

Current Illness: No

ID: 1009946
Sex: F
Age: 35
State: WA

Vax Date: 02/04/2021
Onset Date: 02/05/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: Left arm raised rash, hot, itching, continued to spread. Lymph node swollen like grapefruit size.

Other Meds: None

Current Illness: None

ID: 1009947
Sex: F
Age: 42
State: WA

Vax Date: 01/09/2021
Onset Date: 01/17/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Pertussis

Symptom List: Pain in extremity

Symptoms: Hard red lump that became itchy 8 days after being vaccinated

Other Meds: None

Current Illness: None

ID: 1009948
Sex: F
Age: 68
State: OH

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: All cholesterol medications, sulfa, penicillin

Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: Within 2 hours I started severe vomiting which continued for at least 3 hours. At the same time I could not open my eyes without the room spinning. This kept up until I fell asleep. I awaken about three hours later and vomited again. Then went back to sleep. The next morning I was not nauseous or dizzy, but I had a slight fever, under 100 degrees and was very tired. Did not eat anything until about 6 pm. My stomach was upset most of the day.

Other Meds: Lisinopril, adult multi-vitamins, 250mg of magnesium citrate, vitamin D

Current Illness: None!

ID: 1009949
Sex: F
Age: 11
State: GA

Vax Date: 12/30/2020
Onset Date: 01/08/2021
Rec V Date: 02/07/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Developed fever and headache on 1/8/21. Patient with intermittent fevers and persistent headache. Seen by PCP. Admitted to Facility from 1/21-1/22 for headache and dehydration; symptoms improved with IVF. Increasing headache and complaint of urinary retention then occurred -- readmitted to Facility on 1/25/21. Work-up consistent with myelitis.

Other Meds:

Current Illness:

ID: 1009950
Sex: M
Age: 48
State: AZ

Vax Date: 02/03/2021
Onset Date: 02/07/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: woke at 6am on 2/7 with chills and cold sweats, some minor body aches. started vomiting at approximately 8am and continued to vomit every hour or two until about 4pm. heartburn and nausea throughout the day. could not even keep sips of water down. feeling a little better as I type this at approximately 5:30pm

Other Meds: none

Current Illness: none

ID: 1009951
Sex: F
Age: 51
State: MI

Vax Date: 01/23/2021
Onset Date: 02/06/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: Warm spot on left arm where shot was given. Red circle around shot area about 4-5 inches in diameter.

Other Meds: Hydrochlorothiazide, Januvia, Losartan, loratidine, omeprazole, citalopram, estrodiol

Current Illness: None

ID: 1009952
Sex: M
Age: 88
State: MI

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 02/07/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Extreme confusion High blood pressure was suddenly very high He wandered out of his apartment in the middle of the night. Ambulance picked him up. He was fine before the vaccine.

Other Meds: Eliquis Metprolol Zoloft

Current Illness: Some confusion and memory problems which increased extremely after the vaccination. He started wandering out the house and couldn?t remember anyone. He went to hospital by ambulance where he was treated for high blood pressure and wasn?t able to stand up straight.

ID: 1009953
Sex: F
Age: 37
State: VA

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NKA

Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Fever up to 100.8, full body muscle aches, headache, fatigue, anorexia, injection site soreness

Other Meds: Multivitamins Florastor probiotic

Current Illness: Mild URI, tested negative for Covid 19

ID: 1009954
Sex: F
Age: 59
State: PA

Vax Date: 12/18/2020
Onset Date: 12/18/2020
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Shoulder pain when rotating arm around

Other Meds: Omepraxole Escitalopram Provastanin

Current Illness: None

ID: 1009955
Sex: F
Age: 73
State: GA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Sulfa

Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Within 15 minutes started feeling nauseous which has continued, varying in intensity, as I write this. Additionally today, suddenly I started feeling hot and weak. I checked my oxygen level which was fine at 98, but my pulse was fast at 115 when it is normally in the low to mid 70s and I was just cooking. When I took my blood pressure, it was 142 over 125 a blood pressure than is normal for me. I took a table of Inderal 10mg and within an hour my blood pressure was normal at 117 over 86. My pulse was also 73.. So for now I?m ok.

Other Meds: Multiple vitamin, fish oil, COQ10, glucosamine, garlic, niacin, Lunesta 3 mg, the night before.

Current Illness: None

ID: 1009957
Sex: F
Age: 26
State:

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: Fever, chills, severe headache, muscle aches, numbness in hand (side of injection), sore arm

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm